急性失代偿性心力衰竭患者从入院到出院期间B型利钠肽和中段心房利钠肽原变化对预后的比较评估
Comparative evaluation of B-type natriuretic peptide and mid-regional pro-A-type natriuretic peptide changes from admission to discharge in prognosis of acute decompensated heart failure patients.
作者信息
Stenner Elisabetta, Buiatti Alessandra, Barbati Giulia, Merlo Marco, Sinagra Gianfranco, Biasioli Bruno
机构信息
Department of Laboratory Medicine, A.O.U, Ospedali Riuniti di Trieste, Trieste, Italy.
出版信息
Clin Lab. 2012;58(5-6):585-9.
BACKGROUND
Mid-regional pro-A-type natriuretic peptide (MRproANP) seems to be non-inferior compared to B-type natriuretic peptide (BNP) for heart failure diagnosis and prognosis; however, no previous studies have investigated the MRproANP in-hospital changes in prognostic role. This study aimed to compare the prognostic accuracy of BNP and MRproANP in-hospital changes in acute decompensated heart failure (ADHF) patients.
METHODS
37 patients with either admission/pre-discharge BNP and MRproANP data, were investigated. The combined endpoint was cardiovascular death/heart transplantation/readmission for HF.
RESULTS
BNP and MRproANP had a median decrease of 55% [72;45] and 21% [40; 11] respectively in event-free patients; BNP decrease of 34% [48; 29] but MRproANP increase of 4% [-7; 25] in patients with cardiovascular events. Prognostic accuracy of deltaBNP and deltaMRproANP was similar.
CONCLUSIONS
MRproANP basically trends up in patients with worse outcome and decreases in event-free patients, likely leading to a simpler interpretation although the prognostic accuracy is similar for both peptides.
背景
中段心房利钠肽原（MRproANP）在心力衰竭诊断和预后评估方面似乎不劣于B型利钠肽（BNP）；然而，此前尚无研究探讨MRproANP在院内的预后作用变化。本研究旨在比较BNP和MRproANP在急性失代偿性心力衰竭（ADHF）患者院内变化的预后准确性。
方法
对37例有入院时/出院前BNP和MRproANP数据的患者进行研究。联合终点为心血管死亡/心脏移植/因心力衰竭再次入院。
结果
无事件患者中，BNP和MRproANP的中位数分别下降55%[72；45]和21%[40；11]；发生心血管事件的患者中，BNP下降34%[48；29]，而MRproANP上升4%[-7；25]。ΔBNP和ΔMRproANP的预后准确性相似。
结论
MRproANP在预后较差的患者中基本呈上升趋势，在无事件患者中下降，尽管两种肽的预后准确性相似，但这可能导致其解释更简单。
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